While general U.S. rates of adolescent pregnancy and childbirth have declined over the past four decades, the rate among adolescents in foster care has not reflected this same drop. Decades of research has indicated negative outcomes for both parenting adolescents and their children compared to their non-parenting peers, however, less is understood about the risks, outcomes and needs specific to adolescents who give birth while in foster care. This comprehensive literature review adds to the knowledge of pregnant and parenting mothers in foster care and their children by identifying and summarizing all relevant studies published between 2011 and 2017. Findings indicate that youth in care have high rates of pregnancy and childbirth, experience multiple risks and negative outcomes, and are in need of various supportive services. Implications for research, practice and policy (need to reduce unintended pregnancy and improve circumstances, identifying successful interventions, expanding knowledge of these youth and their children, and developing two-generation interventions) were also explored.